التفاصيل البيبلوغرافية
| العنوان: |
Bleeding risk prediction in elderly patients managed invasively for acute coronary syndromes: External validation of the PRECISE-DAPT and PARIS scores. |
| المؤلفون: |
Montalto, Claudio1 (AUTHOR), Crimi, Gabriele1,2 (AUTHOR) gabriele.crimi@hsanmartino.it, Morici, Nuccia1,3 (AUTHOR), Piatti, Luigi1,4 (AUTHOR), Grosseto, Daniele1,5 (AUTHOR), Sganzerla, Paolo1,6 (AUTHOR), Tortorella, Giovanni1,7 (AUTHOR), De Rosa, Roberta1,8,9 (AUTHOR), De Luca, Leonardo1,10 (AUTHOR), De Luca, Giuseppe1,11 (AUTHOR), Palmerini, Tullio1,12 (AUTHOR), Valgimigli, Marco1,13 (AUTHOR), Savonitto, Stefano1,4 (AUTHOR), De Servi, Stefano1,14 (AUTHOR) |
| المصدر: |
International Journal of Cardiology. Apr2021, Vol. 328, p22-28. 7p. |
| مصطلحات موضوعية: |
*ACUTE coronary syndrome, *OLDER patients, *HEMORRHAGE, *OLDER people, *DECISION making |
| مصطلحات جغرافية: |
PARIS (France) |
| مستخلص: |
We sought to assess and compare the prediction power of the PRECISE-DAPT and PARIS risk scores with regards to bleeding events in elderly patients suffering from acute coronary syndromes (ACS) and undergoing invasive management. Our external validation cohort included 1883 patients older >74 years admitted for ACS and treated with PCI from 3 prospective, multicenter trials. After a median follow-up of 365 days, patients in the high-risk categories according to the PRECISE-DAPT score experienced a higher rate of BARC 3–5 bleedings (p = 0.002) while this was not observed for those in the high-risk category according to the PARIS risk score (p = 0.3). Both scores had a moderate discriminative power (c -statistics 0.70 and 0.64, respectively) and calibration was accurate for both risk scores (all χ2 > 0.05), but PARIS risk score was associated to a greater overestimation of the risk (p = 0.02). Decision curve analysis was in favor of the PRECISE-DAPT score up to a risk threshold of 2%. In the setting of older adults managed invasively for ACS both the PARIS and the PRECISE-DAPT scores were moderately accurate in predicting bleeding risk. However, the use of the PRECISE-DAPT is associated with better performance. • In a validation cohort of 1883 subjects older ≥75 y, the PRECISE-DAPT and PARIS risk scores had similar, moderate performance in terms of calibration and discrimination. • The PRECISE-DAPT risk score had a better performance in stratifying patients into bleeding risk categories with a significant increase in terms of major bleeding in the high-risk category. • An overestimation bias is present for both risk scores, but this appears significantly higher in the PARIS risk score. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
Academic Search Index |
